기존 치료에 반응하지 않는 진균 각막염에서 전방내 보리코나졸 주입술의 임상 효과

Clinical Effects of Intracameral Voriconazole Injection in Patients with Fungal Keratitis Refractory to Conventional Treatment

Purpose: To evaluate clinical effects of intracameral voriconazole injection in fungal keratitis refractory to conventional therapy. Methods: Thirty-eight eyes of 38 patients with fungal keratitis were included in this study. The patients were divided into 3 groups: 13 patients with intracameral voriconazole injection (50 μg/0.1 ml; group A), 11 patients with intracameral amphotericin B injection (10 μg/0.1 ml; group B), and 14 patients with conventional therapy only (group C). Clinical factors including treatment success rate and time to successful treatment were evaluated. Results: Treatment success was accomplished in 12 eyes in group A (92.3%), 10 eyes in group B (90.9%), and 12 eyes in group C (85.7%). Time to treatment success in group A, B, and C was 36.1 ± 10.4 days (p = 0.04), 34.2 ± 7.8 days (p = 0.03), and 49.5 ± 16.7 days, respectively. Patients who had received intracameral voriconazole injection or amphotericin B showed faster fungal keratitis improvement than patients who received conventional treatment. Time to re-epithelialization and time to disappearance of hypopyon showed a similar clinical course. Conclusions: Intracameral voriconazole injection, which has a similar therapeutic effect as intracameral amphotericin B injection in the management of fungal keratitis, can be helpful in the treatment of intractable fungal keratitis.